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Youth Soccer 'Headers' May Lead to Brain Injuries, Study Suggests

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Add soccer to the growing list of youth sports that put student-athletes on the front lines for potential brain injuries.

Athletes who often "head" soccer balls were found to have brain abnormalities similar to those found in patients with traumatic brain injuries (TBIs), according to a study being presented today at the annual meeting of the Radiological Society of North America.

"Heading a soccer ball is not an impact of a magnitude that will lacerate nerve fibers in the brain," Dr. Michael L. Lipton, a co-author of the study and associate director of the Gruss Magnetic Resonance Research Center at the Albert Einstein College of Medicine, said in a statement. "But repetitive heading could set off a cascade of responses that can lead to degeneration of brain cells."

The study examined 32 amateur soccer players (average age: 30.8), all of whom had played soccer since childhood, using a technique called diffusion tensor imaging. (Apologies in advance for getting a little technical here.)

DTI allows doctors to examine the water levels in a brain's white matter. If the water in the white matter moves in a consistent direction, that area of the brain is said to have high fractional anisotropy (FA), whereas a brain with water moving randomly in the white matter has low FA.

"Abnormally low FA within white matter has been associated with cognitive impairment in patients with TBI," Dr. Lipton said.

He and his colleagues asked their subjects to estimate how many times they headed the ball annually. Based on their responses, the researchers compared the brain scans of players who headed the ball frequently and those who did so less often, to determine what differed.

They discovered that soccer players who often headed the ball had "significantly lower" FA in five brain regions, which controlled attention, executive function, and memory.

"What we've shown here is compelling evidence that there are brain changes that look like traumatic brain injury as a result of heading a soccer ball with high frequency," Dr. Lipton said. "Given that soccer is the most popular sport worldwide and is played extensively by children, these are findings that should be taken into consideration in order to protect soccer players."

The researchers determined that if a player headed the ball more than roughly 1,000 to 1,500 times a year, he or she would have low FA in the five regions of the brain they identified.

Schooled in Sports' take: This study is sure to incite outrage from soccer purists, who would decry any attempt to limit the number of heading attempts per game.

But, as National Football League commissioner Roger Goodell said about his own league last month at the Congress of Neurological Surgeons, "People have criticized us as changing the game. I don't believe that. I think we have taken techniques out of the game and improved the game and made it safer—and the game's more popular than ever."

Since football's concussion crisis started drawing serious national attention in 2009, the NFL has become one of the strongest advocates for athlete head safety, specifically with youths.

The league made a noted push to crack down on helmet-to-helmet hits back in October 2010, and started threatening suspensions for egregious hits this season.

Perhaps, given the findings of this study, Major League Soccer could take a stance on the number of headers appropriate for players, especially for youths? Or, better yet, FIFA?

Looks like football may not be the only sport forced to undergo radical rule changes in the coming years to better protect student-athletes' brains.

Photo: Mainz' Elkin Soto, right, goes for a header with Munich's David Alaba, left, during a German Bundesliga soccer match between FSV Mainz 05 and Bayern Munich in Mainz, Germany, on Nov. 27. (Torsten Silz/AP)

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